Observation of an extracted premolar 2.5 years after mineral trioxide aggregate apexification using micro-computed tomography
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초록
Although numerous studies have been conducted on apexification using mineral trioxide aggregate (MTA), direct observation of extracted human teeth after the procedure has been rarely reported. This case report describes a mandibular premolar treated 2.5 years ago and extracted recently for orthodontic treatment. The tubercle of the right mandibular premolar of a 12-year-old boy with dens evaginatus was fractured and the pulp was exposed. The tooth was diagnosed with pulp necrosis and asymptomatic periapical abscess. During the first visit, copious irrigation was performed with 2.5% sodium hypochlorite. Calcium hydroxide paste was placed as an intracanal medicament. The sinus tract had disappeared at the second visit after 3 weeks. MTA was applied on to the bleeding point as a 4-mm-thick layer, followed by a 3-mm-thick gutta-percha filling and resin core build-up. After 2.5 years, the tooth and three other premolars were extracted for orthodontic treatment. The right and left mandibular premolars were scanned with micro-computed tomography to determine the root shape and canal anatomy. Irregular root growth was observed and the root outline of the right mandibular premolar differed from that of the contralateral tooth. Apexification with MTA leads to the formation of roots with irregular morphology, without any pulpal space.
Abstract
Although numerous studies have been conducted on apexification using mineral trioxide aggregate (MTA), direct observation of extracted human teeth after the procedure has been rarely reported. This case report describes a mandibular premolar treated 2.5 years ago and extracted recently for orthodontic treatment. The tubercle of the right mandibular premolar of a 12-year-old boy with dens evaginatus was fractured and the pulp was exposed. The tooth was diagnosed with pulp necrosis and asymptomatic periapical abscess. During the first visit, copious irrigation was performed with 2.5% sodium hypochlorite. Calcium hydroxide paste was placed as an intracanal medicament. The sinus tract had disappeared at the second visit after 3 weeks. MTA was applied on to the bleeding point as a 4-mm-thick layer, followed by a 3-mm-thick gutta-percha filling and resin core build-up. After 2.5 years, the tooth and three other premolars were extracted for orthodontic treatment. The right and left mandibular premolars were scanned with micro-computed tomography to determine the root shape and canal anatomy. Irregular root growth was observed and the root outline of the right mandibular premolar differed from that of the contralateral tooth. Apexification with MTA leads to the formation of roots with irregular morphology, without any pulpal space.
참고문헌 (20)
- Simon S, "The use of mineral trioxide aggregate in one-visit apexification treatment : a prospective study", Int Endod J, 40, pp.186~197 (2007)
- Witherspoon DE, "Retrospective analysis of open apex teeth obturated with mineral trioxide aggregate", J Endod, 34, pp.1171~1176 (2008)
- Farhad AR, "Regeneration or replacement? A case report and review of literature", Dent Traumatol, 32, pp.71~79 (2016)
- Huang GT, "A paradigm shift in endodontic management of immature teeth : conservation of stem cells for regeneration", J Dent, 36, pp.379~386 (2008)
- Hargreaves KM, "Treatment options : biological basis of regenerative endodontic procedures", Pediatr Dent, 35, pp.129~140 (2013)
- Shabahang S, "Treatment options : apexogenesis and apexification", J Endod, 39(Supplement), pp.S26~S29 (2013)
- Alobaid AS, "Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification : a pilot retrospective cohort study", J Endod, 40, pp.1063~1070 (2014)
- Fouad AF, "Healing after regenerative procedures with and without pulpal infection", J Endod, 40(Supplement), pp.S58~S64 (2014)
- Linsuwanont P, "Evaluation of root maturation after revitalization in immature permanent teeth with nonvital pulps by cone beam computed tomography and conventional radiographs", Int Endod J, 50, pp.836~846 (2017)
- Jung IY, "Biologically based treatment of immature permanent teeth with pulpal necrosis : a case series", J Endod, 34, pp.876~887 (2008)
- Nosrat A, "Histologic outcomes of uninfected human immature teeth treated with regenerative endodontics : 2 case reports", J Endod, 41, pp.1725~1729 (2015)
- Peng C, "Histologic findings of a human immature revascularized", regenerated tooth with symptomatic irreversible pulpitis, 2017, pp.43, 905~909
- Shimizu E, "Histologic observation of a human immature permanent tooth with irreversible pulpitis after revascularization", regeneration procedure, 2012, pp.38, 1293~1297
- Bose R, "A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures", J Endod, 35, pp.1343~1349 (2009)
- Holden DT, "Clinical outcomes of artificial root-end barriers with mineral trioxide aggregate in teeth with immature apices", J Endod, 34, pp.812~817 (2008)
- Yassen GH, "Effect of medicaments used in endodontic regeneration technique on the chemical structure of human immature radicular dentin : an in vitro study", J Endod, 39, pp.269~273 (2013)
- Hoshino E, "In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline", Int Endod J, 29, pp.125~130 (1996)
- Windley W 3rd, "Disinfection of immature teeth with a triple antibiotic paste", J Endod, 31, pp.439~443 (2005)
- Yan M, "Mineral trioxide aggregate promotes the odonto", osteogenic differentiation and dentinogenesis of stem cells from apical papilla via nuclear factor kappa B signaling pathway, 2014, pp.40, 640~647
- Tobias Duarte PC, "Histopathological condition of the remaining tissues after endodontic infection of rat immature teeth", J Endod, 40, pp.538~542 (2014)